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Home My WebLink AboutX2019-0209 - Permits (2)OWNER -BUILDER DECLARATION ... .. .. . 1 hereby affirm under penalty of perjury that I am exempt ?romtGe toStractors' State L%ens t reasons indicated below b the checkmark(s) I have placed next to the applicable items) (Section 7031.5, Business and Professions Code: Any cit; oCcoun$y t],YaCroQuiSgs} gPrmQ to G a 1 any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed ptimanMo the'provisionsofmhe s (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. 31.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). - - m ... ❑ I, as owner of the property, or my employees with wages as.tpeir sole sompansatian, wll4ao(_) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The Contractors' State;lj6ens& Law dpBg not'nppry tg fin oQrnor of property who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale. If, hL%erve&, 14e build] t q ling ove, dent fs.sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or improved for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). f I am exempt from licensure under the Contractors' State License Law for the following reason: By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legally sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. Date Signature of Property Owner or Authorized Agent LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class License No Date Contractor Signature WORKERS' COMPENSATION DECLARATION WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($700,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 5706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th performance of the work for which this permit is issued. Policy No. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensatio insurance carrier and policy number are: Policy Number Date is of Agent -- certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and , if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. mDateature of Applicant -- !CLARATION REGARDING CONSTRUCTION LENDING AGENCY ereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). nder's Name Lender's Address my signature below, I certify to each of the following: I am the property owner or authorized to act on the property owner's behalf. I have read this application and the information I have provided is correct. I agree to comply with all applicable city and county ordinances and state laws relating to building construction. I authorize representatives of this city or county to enter the above -identified property for inspection purposes. ,nature of PMDertv Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name RY DECLARATION OF COMPLIANCE WITH CODE OF FEDERALI FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE EXPIRED I I � I U I SUBMITTED ASBESTOS PERMIT EXTENDED Ivlu PERMIT FINAL ASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATE OF�6N Wf5 PROPOSED DEMOLITION OCCUPANCYISSUED 17 SIGNATURE: Date nr, City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIII��I`Illlllllll�llllll�l�ll�lll e^a 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 N Permit Counter Phone (949)644-3288FM SPF NNIO « • • • e "ey Inspection Requests Phone (949)644)644-3255 e • o • • : • ; c e'/ttr«x'g Combination Type - SFPELECMECHPLUM G ••• ••• PERMITS EXPIRE 180 DA YS AFTER ISSUANCE OR LAi Construction Hours: Monday - Friday 7.00 a.m. to 6:30 p.m. and Saturday%from+8:10t Job Address: 704 POPPY AVE NB .9 Description: NEW SFR WIGARAGE & BASEMENT 3510 & 488 SF, DECK(S) 1491 SF Legal Desc.: N TR 673 BILK B LOT 8 Owner: DUGGAN KEITH Contractor: CORNERSTONE CONSTUCTION Address: 23725 VIA ROBLE Address: 15540 ROCKFIELD BLVD STE A 110 COTO DE CAZA CA 92679. IRVINE, CA 92618 Phone: 949-975-0123 Phone: 949-369-1979 Applicant: TEALE MARK Address: 2900 BRISTOL ST BLDG A203 Occupancy Group: COSTA MESA CA 92626 Phone: 949-975.0123 Code Edit : 2016 Type of Construction: V -B -SPR Occupancy Group: R3/U Added /New sq.ft. Bldg: 3574 Added /New sq. ft. Garage: 488 No of Stories: 2 No of Units : 1 Bldg Height: 24 Bldg Sprinklers: Y Flood Zone: X Building Permit Fee: $5,494.00 Plan Check Fee: $0.00 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $106.00 Energy Compliance: $0.00 CA Seismic Safety: $104.00 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $32.00 TOTAL FEE: $15,263.02 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Con State Lie: 1033864 Lie Expire: 12/31/2019 Bus Lie: BT30061583 Lie Exp Date: 1 2/3112 01 9' COMB Permit: X2019-0209 Project No: 2097-2018 Issued Date : 01/2212019 Inspection Area : 5 D 813PECTIOM to•640 p.rm tlwork on Sundays or Holidays Architect: TEALE MARK Address: 2900 BRISTOL ST BLDG A203 ACCREDITED SURETY & CASUALTY Address: COSTA MESA CA 92626 Phone: 949-975-0123 State Lic:CO22162 Engineer: BURKE THOMAS Address: 312 OCEAN AVE Phone: LAGUNA BEACH CA 92651 Phone: 949-494-0776 State Lic:S-005088 Worker's Compensation Insurance Designer: Planning Department - Carrier: ACCREDITED SURETY & CASUALTY Address: Policy No: 1ATCA16000621 Plan check Fee: $0.00 Expire: 11/22/2019 Phone: $0.00 Building Setbacks Rear: 10' Special Conditions: FUEL MOD, VHFHSZ, Grading PC Consultant: Front:. 20' SJH Trans : LANDSLIDE AREA Demolition Fee Left: 3' - Grading Permit Fee: *sf reduction 3/18119* 51✓5 ¢r-gvl . vV`11 In -lieu Housing Fee: Right: 3' Building Dept Adm $0.00 Use Zone: R-1 Parking Spaces: 2 Fire Hazard Zone N Excise Tax: $853.02 Planning Department - Fire Department Additional Fee: $289.90 Plan check Fee: $0.00 Fire Inspection: $0.00 Grading Bonds Fee: $0.00 Fair Share : $0.00 Fire Plan Rev $129.00 Grading PC Consultant: $387.04 SJH Trans : $0.00 Demolition Fee Grading Permit Fee: $1,165.00 In -lieu Housing Fee: $0.00 Building Dept Adm $0.00 Grading PC Fee: $84.96 Public Works Department - General Service $0.00 WQ Insp. Fee: $108.00 Park Dedication : $0.00 Refund Deposit $0.00 PM Plan Check : $247.50 Grading Bond: $0.00 Electrical %: $384.58 San Dist: $803.00 Mechanical W $219.76 NMUSD Fee: $4,360.80 $0.00 Plumbing %: $494.46 $0.00 Plan Check Fee: $15,263.02 Fee Due at Permit Issuance : $0.00 PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: